Journal of Psychosocial Nursing and Mental Health Services
Vol. 46 No. 2 February 2008
Benefits of Psychosocial Rehabilitation Programming in a Treatment Mall
Frankie A. Ballard, MSN, RN, BC
ABSTRACT
Psychiatric patients need educational interventions that help them recover and increase their ability to live and work independently following discharge from the hospital. The psychosocial rehabilitation treatment mall model is designed to meet this educational need. Treatment malls are a new approach to psychosocial rehabilitation for patients in state psychiatric hospitals. Treatment malls provide psychoeducation and skill-building activities in a centralized, school-like setting for participants from all patient care units. It differs from traditional strategies that use decentralized one-on-one or unit-based models. Treatment malls provide a self-directed learning experience that meets the person-centered needs of participants. Evidence is increasing that this psychosocial educational model can provide lasting benefits for psychiatric patients, including symptom management, reduced psychiatric hospital readmission rates, and improved quality of life.
ABOUT THE AUTHOR
Ms. Ballard is a Clinical Nurse Specialist, Dorothea Dix Hospital, Raleigh, North Carolina.
The author acknowledges Carolyn Blue, PhD, RN, and Susanna Winters, RN, BA, for their guidance and support of this article.
The author discloses that she has no significant financial interests in any product or class of products discussed directly or indirectly in this activity, including research support.
Address correspondence to Frankie A. Ballard, MSN, RN, BC, Clinical Nurse Specialist, Dorothea Dix Hospital, 3601 Mail Service Center, Raleigh, NC 27699-3601; e-mail: frankie.ballard@ncmail.net.
The Case for Mandatory Outpatient Treatment
Mary Cullen-Drill, RN, APN, C; and Kathleen Schilling, RN, APN, C
ABSTRACT
Research on the effectiveness of mandatory outpatient treatment, which is court-ordered mental health follow up, supports its use with individuals who have serious mental illness. Many states already have some kind of mandatory outpatient treatment in place, but it is often underused. Much of the criticism of mandatory outpatient treatment is based on the fact that research demonstrating its efficacy is limited and that its implementation infringes on individuals’ rights. However, sufficient evidence can be found in the literature to support its use for some individuals with chronic mental illness living in the community. In addition, the ethical principles of beneficence, utilitarianism, and communitarianism support its use in some situations. Mandatory outpatient treatment is an ethical and effective method shown to be helpful with individuals who have mental illness and are nonadherent to treatment. Expanding its use in appropriate situations is in the best interest of those with serious mental illness and society in general.
ABOUT THE AUTHORS
Ms. Cullen-Drill and Ms. Schilling are Advanced Practice Nurses, Psychiatry, Saint Clare’s Behavioral Health Services, Denville, and in private practice, Montclair, New Jersey. Ms. Cullen-Drill is also a doctoral candidate in the DrNP program at Columbia University School of Nursing.
Address correspondence to Mary Cullen-Drill, RN, APN, C, Advanced Practice Nurse, Psychiatry, Saint Clare’s Behavioral Health Services, 50 Morris Avenue, Denville, NJ 07834; e-mail: mcullendrill@aol.com.
The LORS-Enabled Dialogue: Improving Insight in Psychotic Illnesses
Sharon Sousa, EdD, APRN, BC
ABSTRACT
Patients often underestimate the degree of their psychiatric illness and consequently have difficulty effectively participating in interventions to optimize recovery. This problem of insight may be connected with neurological difficulties resulting in poor explicit memory; however, most interventions nurses use to help patients improve their understanding of illness rely on explicit memory. The discrepancy between clinician and patient scores on the Levels of Recovery from Psychotic Disorders Scale (LORS) has been correlated with measures of insight and psychopathology. This difference can be used in a therapeutic dialogue, the LORS-Enabled Dialogue (LED). This intervention engages patients’ implicit memory, asking a series of open-ended questions and using motivational interviewing to help promote patients’ attainment of life goals. Large-scale studies of this intervention are currently underway and should help better define questions about the effectiveness of the LED.
ABOUT THE AUTHOR
Dr. Sousa is Associate Professor, Community Nursing, University of Massachusetts Dartmouth, North Dartmouth, Massachusetts.
The author discloses that she has no significant financial interests in any product or class of products discussed directly or indirectly in this activity. This study was funded by an unrestricted grant from Lilly Pharmaceuticals.
The author thanks the many patients and clinicians who have helped inspire her work throughout the years in the development of the LORS.
Address correspondence to Sharon Sousa, EdD, APRN, BC, Associate Professor, Community Nursing, University of Massachusetts Dartmouth, 285 Old Westport Road, North Dartmouth, MA 02747-2300; e-mail: ssousa@umassd.edu.
